Using patient-reported outcome measures during the management of patients with end-stage kidney disease requiring treatment with haemodialysis (PROM-HD): a qualitative study
Year: 2021
Type: article
Abstract: OBJECTIVES: Patients undergoing haemodialysis report elevated symptoms and reduced health-related quality of life, and often prioritise improvements in psychosocial well-being over long-term survival. Systematic collection and use of patient-reported outcomes (PROs) may help support tailored healthcare and improve outcomes. This study investigates the methodological basis for routine PRO assessment, particularly using electronic formats (ePROs), to maximise the potential of PRO use, through exploration of the experiences, views and perceptions of patients and healthcare professionals (HCPs) on implementation and use of PROs in haemodialysis settings. STUDY DESIGN: Qualitative study. SETTING AND PARTICIPANTS: Semistructured interviews with 22 patients undergoing haemodialysis, and 17 HCPs in the UK. ANALYTICAL APPROACH: Transcripts were analysed deductively using the Consolidated Framework for Implementation Research (CFIR) and inductively using thematic analysis. RESULTS: For effective implementation, the potential value of PROs needs to be demonstrated empirically to stakeholders. Any intervention must remain flexible enough for individual and aggregate use, measuring outcomes that matter to patients and clinicians, while maintaining operational simplicity. Any implementation must sit within a wider framework of education and support for both patients and clinicians who demonstrate varying previous experience of using PROs and often confuse related concepts. Implementation plans must recognise the multidimensionality of end-stage kidney disease and treatment by haemodialysis, while acknowledging the associated challenges of delivering care in a highly specialised environment. To support implementation, careful consideration needs to be given to barriers and facilitators including effective leadership, the role of champions, effective launch and ongoing evaluation. CONCLUSIONS: Using the CFIR to explore the experiences, views and perceptions of key stakeholders, this study identified key factors at organisational and individual levels which could assist effective implementation of ePROs in haemodialysis settings. Further research will be required to evaluate subsequent ePRO interventions to demonstrate the impact and benefit to the dialysis community.
Source: BMJ Open
Authors: Nicola Elzabeth Anderson, Christel McMullan, Melanie Calvert, Mary Dutton, Paul Cockwell, Olalekan L Aiyegbusi, Derek Kyte
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
Funders: Gilead Sciences, Patient-Centered Outcomes Research Institute, Macmillan Cancer Support, University Hospitals Birmingham NHS Foundation Trust, UK Research and Innovation, National Institute for Health and Care Research, Astellas Pharma, Surgical Reconstruction and Microbiology Research Centre, Birmingham Biomedical Research Centre, National Institute for Health Research Applied Research Collaboration West, UCB Pharma, Daiichi Sankyo Europe
Awards: The use of an electronic Patient-Reported Outcome Measure (ePROM) in the Management of Patients with Advanced Chronic Kidney Disease – A Pilot/Feasibility Study for a Randomised Controlled Trial., Using electronic Patient-Reported Outcome Measures (ePROMs) to promote quality of care and safety in the management of patients with End Stage Kidney Disease requiring treatment with Haemodialysis (HD) in research and routine clinical settings: a mixed-methods study., NIHR Senior Investigator Award
OpenAlex ID: W3194355198